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Thursday, March 29, 2018

Ky. Hospital Assn. joins Bevin suit against 16 Kentuckians who say changes he and feds are making to Medicaid are illegal

By Melissa Patrick
Kentucky Health News

The Kentucky Hospital Association has joined Gov. Matt Bevin's federal lawsuit against the 16 Kentuckians who filed a suit that claims his changes to the state's Medicaid program are illegal, stating in the court document that Kentucky hospitals will "suffer an injury" if the court doesn't rule them to be legal. That is based on Bevin's threat to end the 2014 expansion of Medicaid if a court blocks his changes.

In January, 16 Kentuckians filed a lawsuit claiming that federal officials violated federal law and perhaps the U.S. Constitution by approving changes to Kentucky's Medicaid program and declaring their intent to approve similar changes in other states. The suit did not name Bevin or his subordinates as defendants. The plaintiffs are represented by the National Health Law Program, a public-interest law firm; the Kentucky Equal Justice Center; and the Southern Poverty Law Center.

In February, Bevin sued the Kentuckians and the groups representing them and asked for the case to be decided in Kentucky, and "seeks to ensure that, as the architect and administrator of the waiver, the Commonwealth's voice is heard," his office said in a press release.

The state's new Medicaid plan, called Kentucky HEALTH for "Helping to Engage and Achieve Long Term Health," includes, among other things: work or training requirements, lock-out periods for failure to comply, and premiums and co-payments. The changes are set to be phased in, starting in July, and will largely impact Kentuckians who have gained Medicaid coverage through the expansion, which covers people with incomes up to 138 percent of the federal poverty level.

Bevin's threat to roll back the expansion program if Kentucky HEALTH is ruled unlawful seems to have pushed the hospital association to join his case.

KHA Senior Vice President Nancy Galvagni told the trade journal Inside Health Policy that hospitals plan to work with Medicaid recipients to help them meet the new requirements, Lisa Gillespie reports for WFPL.

“We’re supporting the waiver because we support expansion,” Galvagni told IHP. “We want to have the expansion in place, and if it’s contingent upon the waiver being in place, we want to make the waiver work.”

"If judges rule Bevin’s plan illegal and he makes good on his threat to completely do-away with Medicaid expansion, it would have a devastating impact on hospital finances," Gillespie writes. "Hospitals in Kentucky had $552 million in charity care costs in 2015 after the state expanded Medicaid. That compared with $2.4 billion in those costs from 2012."

KHA attorney Wesley Butler, of the Lexington-based law firm Barnett Benvenuti & Butler, told Gillespie that hospitals need to be included because health providers will be affected by the many changes.

“We recognize that the government has to make some difficult choices to manage a large program,” Butler said. “We would much rather us be proactive in managing those issues rather than allowing them to deteriorate as the program tends to do with a lack of innovation.”

The lawsuit says, “The absence of health care providers in this legal dispute would omit a principal party that actually provides the necessary health care services for a government health care program. . . . If the implementation of Kentucky HEALTH is found to violate the Constitution, its invalidation will have a state-wide impact on Kentucky health care providers.”

Gillespie points out that the Kentuckians' suit currently resides in the D.C. federal court under Judge James Boasberg, a judge appointed by former President Barack Obama. Most district judges in the Eastern District of Kentucky, where Bevin filed his suit, were appointed by Republican presidents.

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Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.Republication of any KHN material with proper credit is hereby authorized, but if the republication is longer than a news brief we ask that it contain the first sentence of this paragraph. For our site that features articles of lasting importance, go here.